The impetus for this investigation stemmed from reports that the prevalence of depression and anxiety amongst the Afghan population in South East (SE) Melbourne is particularly high. These reports came from both Afghan community members and health and community workers. This qualitative study identified and explored a range of topics to provide information that aims to ultimately increase the capacity of health and community workers to promote the mental health and wellbeing of Afghan women in South East Melbourne, with a particular focus on pregnancy and childbirth.

In‐depth interviews were conducted with health and community workers in contact with the Afghan community and focus group discussions were held with Afghan community representatives in October and November 2009 to identify and explore:

• cultural practices around pregnancy and childbirth in Afghanistan to understand usual roles and responsibilities of family members and the health system in Afghanistan;

• acceptable ways of dealing with distress in Afghan cultures in order to understand appropriate community based responses to promoting mental health;

• factors that contribute to poor mental health and wellbeing for Afghan women in this area in order to better understand the source of poor mental health for this population; and,

• barriers to appropriate antenatal care.

The findings revealed complex transitions and social change required by Afghan refugees upon arrival in Australia. Practices around pregnancy and childbirth in Afghan cultures usually involve relatively intensive support of the extended family. This means that in Australia the husband plays a greater role due to the absence of the family network, and the role of maternal and child health support is crucial. Some cultural practices relating to pregnancy could potentially compound feelings of isolation for some Afghan women ‐ such as restrictions upon movement during pregnancy and for 40 days after the birth.

The trauma of conflict and the refugee flight were noted as contributing factors to poor mental health. Post‐migration stressors reported by the majority of participants included feelings of isolation, related to a perceived lack of community in SE Melbourne, compounded by poor access to transport. The impact of strained and sometimes dysfunctional spousal relationships associated with adjusting to life in Australia, often after long periods of separation following the migration process to Australia, were reported by a significant majority of participants. Strategies to address poor mental health in the Afghan community should provide information about mental health, sexual and reproductive health and support couples to foster positive spousal relationships. An existing unfunded proposal that engages Afghan parents in conjunction with antenatal care may be an appropriate vehicle for delivering this information, and would fill a gap in existing antenatal services for Afghan parents.